There are many instances in life where preconceived notions don’t line up with the way things can actually be. One example: many people think bunions are caused by women’s choices in footwear, particularly high-heeled shoes.

Whereas pumps and stilettos can exacerbate an existing condition, they are not actually the instigators for these common deformities. This is proven by the simple fact that men and adolescents—demographics who rarely opt for high-heeled shoes—also sometimes develop bunions (even though they are more common for adult females).

Recognizing the signs and symptoms of this condition is important so you can receive proper treatment.

Bunions 101

A bunion is a fairly common deformity that develops at the base of the big toe, right where it connects to the foot. The condition develops at the bones on each side of the metatarsophalangeal (MTP) joint—the joint that acts as a hinge for your toe—and can result in a rather uncomfortable situation. When the phalange bone of the toe starts angling inward, the MTP joint begins protruding out of place. This creates the signature bump on the inside edge of the foot.

The prominent sign of this condition is that unusual bump, but an inward-angled big toe is also a clue that a bunion has developed. Other symptoms that accompany the condition include redness, swelling, pain, and irritation. Because of the abnormal positioning, corns and calluses are more likely to form in the area. Wearing shoes or even walking can be difficult or painful.

A related condition, called a bunionette or “tailor’s bunion,” can also develop on the other side of the foot. In this case, the MTP joint for the small toe is the one that becomes unstable. Much like with a traditional bunion, the MTP joint is forced out, while the little toe starts to point inward. Bunionettes can develop over time as the foot widens as you become older.

Treating Bunions

When it comes to treatment for bunions, our hope is to be able use only conservative, nonsurgical methods. These include:

  • Shoe choices – Finding footwear that offers wide, deep toe boxes can be beneficial. This avoids having too much pressure or friction on the affected area.
  • Ice – Ice the bunion for about fifteen minutes at a time can help to reduce pain and inflammation. It is important to make sure that ice is not placed directly on the skin. Wrap it in a thin cloth or towel to avoid skin damage.
  • Medication – Always consult with our office before administering medicine so we can provide recommendations and appropriate dosage amounts, but non-steroidal anti-inflammatory drugs (NSAIDs) are useful for managing pain and inflammation.
  • Custom orthotics – Our office can create a special pair of orthotic devices that are custom-fitted to the foot. This is used to redistribute pressure on the foot and keep it away from the affected area.

For patients who experience severe pain and restricted mobility, we may recommend bunion surgery procedures like:

  • Osteotomy – This surgery entails small cuts being made into bones to help realign the joint into its natural position. Plates, pins, or screws may be used to fix the cut bone and keep everything in place.
  • Arthrodesis – For patients who also have severe arthritis—possibly even caused by the bunion—we may recommend arthrodesis to remove arthritic joint surfaces. As with osteotomy, plates, pins, and screws can help to hold surfaces together while the affected bones mend. We also sometimes use arthrodesis in cases where previous bunion surgery has been unsuccessful.
  • Exostectomy – This procedure is rarely used alone, but it is centered on removing the bump from the big toe’s MTP joint. Most often, it exostectomy is performed in conjunction with osteotomy.

Other surgical procedures may be used to repair the connective tissues (ligaments, tendons) surrounding the big toe—to correct any imbalances in the affected joint. In some cases, we may recommend resection arthroplasty, which is removal of the damaged part of the MTP joint.

Here at Wilks Advanced Foot Care, we provide foot care for you and your entire family. If you have a child living with the pain and discomfort of a juvenile bunion, let us help. Contact our Roseburg, OR office by calling (541) 673-0742 or using our online form and scheduling an appointment today.

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